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Respiratory morbidity, lung function and fitness assessment after bronchopulmonary dysplasia

Journal of Perinatology volume 35, pages 1037–1042 (2015)Cite this article

Subjects

Abstract

Objective:

To examine respiratory morbidity and exercise capacity at school age in children after bronchopulmonary dysplasia (BPD).

Study Design:

Former preterm children after BPD (n=23), without BPD (n=33) and term controls (n=33) were compared using respiratory health questionnaire, spirometry and six-minute walk test (6MWT).

Result:

Wheezing was more frequent in BPD group (61%) vs non-BPD group (24%; P<0.001) and controls (15%; P<0.001) in the first year of life and until a year before inclusion. The children after BPD had lower mean value (P<0.001) for forced expiratory volume in 1 s (75.3%) vs non-BPD (89.8%) and controls (91.1%). Six-minute walking distance was lower after BPD by 58.3 m compared with non-BPD group (P=0.002) and by 53.7 m compared with controls (P=0.005). After adjusting for confounding factors the difference was not significant anymore.

Conclusion:

More frequent wheezing and reduced lung function persist into school age after BPD.

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References

  1. Cazzato S, Ridolfi L, Bernardi F, Faldella G, Bertelli L . Lung function outcome at schoolage in very low birth weight children. Pediatr Pulmonol 2013; 48: 830–837.

    Article  PubMed  Google Scholar 

  2. Doyle LW and the Victorian Infant Collaborative Study Group. Respiratory function at age 8-9 years in extremely low birthweight/very preterm children born in Victoria in 1991-1992. Pediatr Pulmonol 2006; 41: 570–576.

    Article  PubMed  Google Scholar 

  3. Doyle LW, Faber B, Callanan C, Freezer N, Ford GW, Davis NM . Bronchopulmonary dysplasia in very low birth weight subject and lung function in late adolescence. Pediatrics 2006; 118: 108–113.

    Article  PubMed  Google Scholar 

  4. Kilbride HW, Gelatt MC, Sabath RJ . Pulmonary function and exercise capacity for ELBW survivors in preadolescence: effect of neonatal chronic lung disease. J Pediatr 2003; 147: 488–493.

    Article  Google Scholar 

  5. Narang I, Rosenthal M, Cremonesini D, Silverman M, Bush A . Longitudinal evaluation of airway function 21 years after preterm birth. Am J Respir Crit Care Med 2008; 178: 74–80.

    Article  PubMed  Google Scholar 

  6. Gross SJ, Iannuzzi DM, Kveselis DA, Anbar RD . Effect of preterm birth on pulmonary function at school age: a prospective controlled study. J Pediatr 1998; 133: 188–192.

    Article  CAS  PubMed  Google Scholar 

  7. ATS Committee on Proficiency Standards for Clinical Pulmonary Function Laboratories. ATS Statement: guidelines for the six-minute walk test. Am J Respir Crit Care Med. 2002; 166: 111–117.

    Article  Google Scholar 

  8. Cunha MT, Rozov T, de Oliveira RC, Jardim JR . Six-minute walk test in children and adolescents with cystic fibrosis. Pediatr Pulmonol 2006; 41: 618–622.

    Article  PubMed  Google Scholar 

  9. Lesser DJ, Fleming MM, Maher CA, Kim SB, Woo MS, Keens TG . Does the 6-min walk test correlate with the exercise stress test in children? Pediatr Pulmonol 2010; 45: 135–140.

    Article  PubMed  Google Scholar 

  10. Smith LJ, van Asperen PP, McKay KO, Selvadurai H, Fitzgerald AD . Reduced exercise capacity in children born very preterm. Pediatrics 2008; 122: 287–293.

    Article  Google Scholar 

  11. Tsopanoglou SP, Davidson J, Goulart AL, de Moraes Barros MC, Dos Santos AM . Functional capacity during exercise in very-low-birth-weight premature children. Pediatr Pulmonol. 2014; 49: 91–98.

    Article  PubMed  Google Scholar 

  12. Štucin Gantar I, Babnik J, Kornahuser Cerar L, Šinkovec J, Wraber B . Prenatal and postnatal risk factors for devopong BPD. Signa Vitae 2011; 6: 46–51.

    Article  Google Scholar 

  13. Shennan AT, Dunn MS, Ohlsson A, Lennox K, Hoskins EM . Abnormal pulmonary outcomes in premature infants: prediction from oxygen requirement in the neonatal period. Pediatrics 1988; 82: 527–532.

    CAS  PubMed  Google Scholar 

  14. American Thoracic Society. Standardisation of spirometry. 1994 Update. Am J Respir Crit Care Med 1995; 152: 1107–1136.

    Article  Google Scholar 

  15. Polgar G, Promadhat V . Standard values. In: Polgar G, Promadhat V (eds). Pulmonary Function Testing in Children: Techniques and Standards. WB Saunders: Philadelphia, 1971 pp 87–212.

    Google Scholar 

  16. Lammers AE, Hislop AA, Flynn Y, Haworth SG . The 6-minute walk test: normal values for children of 4-11 years of age. Arch Dis Child 2008; 93: 464–468.

    Article  CAS  PubMed  Google Scholar 

  17. American Thoracic Society. European Respiratory Society. ATS/ERS Recommendations for standardized procedures for the online and offline measurement of exhaled lower respiratory nitric oxide and nasal nitric oxide. Am J Respir Crit Care Med 2005; 171: 912–930.

    Article  Google Scholar 

  18. Fawke J, Lum S, Kirkby J, Hennessy E, Marlow N, Rowell V et al. Lung function and respiratory symptoms at 11 years in children born extremely preterm. The EPICure study. Am J Respir Crit Care Med 2010; 182: 237–245.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Vrijlandt EJLE, Boezen HM, Gerritsen J, Stremmelaar EF, Duiverman EJ . Respiratory health in prematurely born preschool children with and without bronchopulmonary dysplasia. J Pediatr 2007; 150: 256–261.

    Article  CAS  PubMed  Google Scholar 

  20. Vom Hove M, Prenzel F, Uhlig HH, Robel-Tillig E . Pulmonary outcome in former preterm, very low birth weight children with bronchopulmonary dysplasia: a case-control follow-up at school age. J Pediatr 2014; 164: 40–45.

    Article  PubMed  Google Scholar 

  21. Gibson AM, Reddington C, McBride L, Callanan C, Robertson C, Doyle LW . Lung function in adult survivors of very low birth weight, with and without bronchopulmonary dysplasia. Pediatr Pulmonol 2014; 50: 987–994.

    Article  PubMed  Google Scholar 

  22. Filippone M, Bonetto G, Cherubin E, Carraro S . Childhood course of lung function in survivors of bronchopulmonary dysplasia. JAMA 2009; 302: 1418–1420.

    Article  CAS  PubMed  Google Scholar 

  23. Doyle LW, Cheung MM, Ford GW, Olinsky A, Davis NM, Callanan C . Birth weight &lt;1501 g and respiratory health at age 14. Arch Dis Child 2001; 84: 40–44.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  24. Narang I, Baraldi E, Silverman M, Bush A . Airway function measurements and the long- term follow-up of survivors of preterm birth with and without chronic lung disease. Pediatr Pulmonol 2006; 41: 497–508.

    Article  PubMed  Google Scholar 

  25. Ronkainen E, Dunder T, Peltoniemi O, Kaukola T, Marttila R, Hallman M . New BPD predicts lung function at school age: Follow-up study and meta-analysis. Pediatr Pulmonol 2015 (e-pub ahead of print).

  26. Bhandari A, McGrath-Morrow S . Long-term pulmonary outcomes of patients with bronchopulmonary dysplasia. Semin Perinatol 2013; 37: 132–137.

    Article  PubMed  Google Scholar 

  27. Bush A . Update in pediatric lung disease 2006. Am J Respir Crit Care Med 2007; 175: 532–540.

    Article  PubMed  Google Scholar 

  28. Quanjer PH, Stanojevic S, Cole TJ, Baur X, Hall GL, Enright PL et al. Multi-ethnic reference values for spirometry for the 3-95 year age range: the global lung function 2012 equations. Eur Respir J 2012 40: 1324–1343.

  29. Li AM, Yin J, Yu CC, Tsang T, So HK, Wong E et al. The six-minute walk test in healthy children: reliability and validity. Eur Respir J 2005; 25: 1057–1060.

    Article  CAS  PubMed  Google Scholar 

  30. Ulrich S, Hildebrandt FF, Treder U, Fishcler M, Keusch S, Speich R et al. Reference values for the 6-minute walk test in healthy children and adolescents in Switzerland. BMC Pulm Med 2013; 13: 49.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Baraldi E, Bonetto G, Zacchello F, Filippone M . Low exhaled nitric oxide in school-age children with bronchopulmonary dysplasia and airflow limitation. Am J Respir Crit Care Med 2005; 171: 68–72.

    Article  PubMed  Google Scholar 

  32. Mieskonen ST, Malmberg LP, Kari MA, Pelkonen AS, Turpeinen MT, Hallman NM et al. Exhaled nitric oxide at school age in prematurely born infants with neonatal chronic lung disease. Pediatr Pulmonol 2002; 33: 347–355.

    Article  PubMed  Google Scholar 

  33. Lum S, Kirkby J, Welsh L, Marlow N, Hennessy E, Stocks J . Nature and severity of lung function abnormalities in extremely pre-term children at 11 years of age. Eur Respir J 2011; 37: 1199–1207.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Pulmonology, University Children’s Hospital, University Medical Centre Ljubljana, Ljubljana, Slovenia

    M Praprotnik & U Krivec

  2. Division of Perinatology, Department of Gynecology and Obstretics, University Medical Centre Ljubljana, Ljubljana, Slovenia

    I Stucin Gantar & M Lučovnik

  3. Department of Allergology, Rheumatology and Clinical Immunology, University Children's Hospital, University Medical Centre Ljubljana, Ljubljana, Slovenia

    T Avčin

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  1. M Praprotnik
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Correspondence to M Praprotnik.

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Praprotnik, M., Stucin Gantar, I., Lučovnik, M. et al. Respiratory morbidity, lung function and fitness assessment after bronchopulmonary dysplasia. J Perinatol 35, 1037–1042 (2015). https://doi.org/10.1038/jp.2015.124

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  • DOI: https://doi.org/10.1038/jp.2015.124

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